I am a 60-ish married engineer that has dealt with moderate eczema my entire life, primarily through the use of topical steroids. In early 2012 things started going wrong, and this blog is a personal diary of my journey through Topical Steroid Withdrawal, also known as Red Skin Syndrome, Topical Steroid Addiction, or Steroid Induced Eczema. I have been completely free from all steroids since July 9, 2013. Please see www.itsan.org for more info and feel free to post here!

Thursday, May 25, 2017

This graph is a symbolic representation of my major symptoms just prior to and going through topical steroid withdrawal. It is not based on a detail log, rather it is from memory and is filtered to eliminate confusion from the "Zyrtec withdrawal" I went through before I knew what RSS and TSW was. Note that many lesser symptoms are not shown at all, such as edema (swelling), elephant skin, infections, enlarged lymph nodes, and oozing. Each major peak shown after starting TSW reflects an approximate one year cycle of major flares, each less severe than the one prior. Keep in mind that I was born with eczema and am a 50 plus year user of topical steroids across the entire strength range. You mileage will vary.

I wanted to use this graph to make a few points:

1. TSW is one hell of a roller coaster ride. I was never suicidal, but the peaks were definitely in the "just shoot me now" range. The magnifying glass thingy illustrates that although the curves shown are smooth, drastic changes can happen on a daily, even hourly, basis. The analogy is that the main curves are the rollercoater tracks, but it's a wood rollercoaster and you get shaken around a lot.

2. It is my opinion that there's not a damn thing one can do to make the ride any shorter or less severe. It is human nature to want to control one's environment, but other than anti-itch medication (hydroxyzine) and sleeping pills (Ambien) there is nothing that has any non-anecdotal evidence that it does anything at all to help. I've posted about alternative medicine before, and may again, but for now, there's a joke that perfectly summarizes the issue for me: You know what they call alternative medicine that works? Medicine.

3. Speaking of alternative medicine, TSW has one primary feature, that roller coaster part, that makes it perhaps the most susceptible condition one can have where false-causal relationships can be made. Let me illustrate. Consider Point A on the graph. If at this point you were to give something a try, say probiotics, you would be absolutely convinced that this change had an awesome affect on your symptoms. You'd go on Facebook TSW support groups and yell "Benghazi!", oh wait, wrong subject, you'd yell "Gut health!" at the top of your keyboard lungs and feel smug that you had made a discovery that will make you loved and admired.

For me, and this is a true story, about at the "Point A" time I had given up on diet changes and was eating pretty much anything I wanted. I was still eating good stuff, my wife assured that I would, but I was eating ice cream, having hot chocolate, candy, whatever made me feel that life was worth living, especially since I was losing weight due to the fact that I was a nuclear blast furnace. I decided mere ice cream was not enough, so I poured on some of that Smucker's chocolate hard shell ice cream topper crap, you know the stuff full of the bad fats that solidify when cooled, and I was in heaven, at least for the 30 seconds it took to shove it in my pie-hole. I'm not kidding, the very next day my rollercoaster car pointed down and I accelerated towards normalcy like never before.

Do I think that Smucker's chocolate hard shell ice cream topper was the reason for the sudden improvement? Of course not. But the evidence that it was is as strong as any claims I have seen for anything else, such as leaky gut, homeopathy, anti-histamine foods, alkaline water, ph balance, urine therapy, blah, blah, blah.

What could have happened if I decided to pour on the Smucker's at Point B? Well, I could just as well be convinced that Smucker's hard shell ice cream topper should be tossed in the garbage right along with my Topicort. And I'd be wrong. Well, about the Smucker's chocolate hard shell ice cream topper anyway.

Here's the bottom line: Nobody, and I mean nobody, can claim that anything they have done has had an effect on their healing. Why? Because they have no way of knowing what would have happened if they had NOT done it. This is the definition of anecdotal logical fallacy.

The only folks that could make any claims about changes are those familiar with many cases of TSW and have held their hands through the ordeal. Dr. Rapaport has done precisely this for thousands of patients and he makes the outright claim that dietary changes have no effect.

By the way, I feel fantastic but minor itching and rash have reappeared on my right hand and right foot. I am coming up on my four year anniversary and I am hoping that even though I can hardly call this a flare, it is my last one. Even if this is my steady state condition I would be okay with that.

"Addiction to (Topical) Steroids is a serious problem which reaches tragic proportions in some cases. It is more common than realized, sly and seductive and will be prevented only when the physician becomes as impressed with the capacity of the steroids to do harm as they are with their power to suppress, not cure, virtually any inflammatory disorder." - Dr. Albert M. Kligman M.D. Ph.D. and Dr. Peter J. Frosch M.D., International Society of Topical Dermatology Journal, 1979